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Mohamed G. Al-Kuwari, Izzeldin A. Ibrahim, Eiman M. Al Hammadi and John J. Reilly

Background:

The first Qatar Active Healthy Kids (QAHK) Report Card was developed in 2015–2016. It is a synthesis of the available evidence on physical activity in children and youth in the state of Qatar—an assessment of the state of the nation. The report card is important for future physical activity advocacy, policy, and program development.

Methods:

The QAHK Report Card was inspired by the Active Healthy Kids Scotland 2013 Report Card. The methodology used in Scotland’s report card was adapted for Qatar. A Working Group identified indicators for physical activity and related health behaviors, and evaluated the available data on these indicators. The card grades were determined by the percentage of children meeting guidelines or recommendations.

Results:

The 2016 QAHK Report Card consisted of 9 indicators: 6 Physical Activity and Health Behaviors and Outcomes, and 3 Settings and Influences on these health behaviors and outcomes. The indicator National Policy, Strategy, and Investment was assigned the highest grade (B). Four indicators were assigned D grades: Sedentary Behavior, Dietary Habits, Organized Sports Participation, and Family and Peer Influence. Physical Activity and Obesity were both graded F. Two indicators could not be graded due to insufficient data and/or absence of a recommendation: Active and Outdoor Play, and Community and School Influence.

Conclusions:

The QAHK Report Card identified weaknesses and gaps in the evidence on physical activity and health in children and youth in Qatar. The quality of evidence was poor for some indicators, with some data collection methods of limited validity and reliability, or only available for a limited age range, so the grades are best estimates of the current situation in Qatar. Future surveys and research using objective physical activity measures will support the development of a second QAHK Report Card by 2018.

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Anne Martin, Paul Kelly, Jessica Boyle, Fenella Corlett and John J. Reilly

Purpose:

This study estimated the contribution of walking to/from school to objectively measured daily moderate-vigorous intensity physical activity (MVPA) in individuals and populations.

Methods:

MEDLINE, PsycINFO and SPORTDiscus were systematically searched up to February 2015. Two reviewers independently screened titles/abstracts/full-text articles, and assessed study quality.

Results:

Of 2430 records, 129 were eligible for full-text screening. Twelve studies met the inclusion criteria of reporting objectively obtained measures of MVPA (total and while walking to/from school) in children and adolescents. The weighted mean MVPA accumulated in walking to and from school was 17 min/day in primary school pupils (9 samples, n = 3422) and 13 min/day in high school pupils (4 samples, n = 2600). Pooled analysis suggested that walking to and from school contributed 23% and 36% of MVPA on schooldays in primary school age children and high school pupils, respectively. All included studies were of high methodological quality.

Conclusions:

Walking to and from school makes a meaningful contribution to individual schoolday MVPA for active commuters in western countries. Since schooldays represent only around half of all days, and prevalence of walking to school is low in many countries, the contribution of walking to school to population MVPA is probably low.

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Robert M. Ojiambo, Chris Easton, Jose A. Casajús, Kenn Konstabel, John J. Reilly and Yannis Pitsiladis

Background:

Urbanization affects lifestyles in the developing world but no studies have assessed the impact on objectively measured physical activity in children and adolescents from sub-Saharan Africa.

Purpose:

To compare objectively measured habitual physical activity, sedentary time, and indices of adiposity in adolescents from rural and urban areas of Kenya.

Methods:

Physical activity and sedentary time were assessed by accelerometry for 5 consecutive days in 97 (50 female and 47 male) rural and 103 (52 female and 51 male) urban adolescents (mean age 13 ± 1 years). Body Mass Index (BMI) and BMI z-scores were used to assess adiposity.

Results:

Rural males spent more time in moderate-to-vigorous intensity physical activity (MVPA) compared with urban males (68 ± 22 vs. 50 ± 17 min, respectively; P < .001). Similarly, Rural females spent more time in MVPA compared with urban females (62 ± 20 vs. 37 ± 20 min, respectively; P < .001). Furthermore, there were significant differences in daily sedentary time between rural and urban subjects. Residence (rural vs. urban) significantly (P < .001) influenced BMI z-score (R 2 = .46).

Conclusion:

Rural Kenyan adolescents are significantly more physically active (and less sedentary) and have lower indices of adiposity compared with urban adolescents and this is a likely refection of the impact of urbanization on lifestyle in Kenya.

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Anne Martin, Mhairi McNeill, Victoria Penpraze, Philippa Dall, Malcolm Granat, James Y. Paton and John J. Reilly

The Actigraph is well established for measurement of both physical activity and sedentary behavior in children. The activPAL is being used increasingly in children, though with no published evidence on its use in free-living children to date. The present study compared the two monitors in preschool children. Children (n 23) wore both monitors simultaneously during waking hours for 5.6d and 10h/d. Daily mean percentage of time sedentary (nontranslocation of the trunk) was 74.6 (SD for the Actigraph and 78.9 (SD 4.3) for activPAL. Daily mean percentage of time physically active (light intensity physical activity plus MVPA) was 25.4 (SD for the Actigraph and 21.1 (SD 4.3) for the activPAL. Bland-Altman tests and paired t tests suggested small but statistically significant differences between the two monitors. Actigraph and activPAL estimates of sedentary behavior and physical activity in young children are similar at a group level.

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Chiaki Tanaka, Xanne Janssen, Mark Pearce, Kathryn Parkinson, Laura Basterfield, Ashley Adamson and John J. Reilly

Background: Previous studies have reported on the associations between obesity and sedentary behavior (SB) or physical activity (PA) in children. This study examined longitudinal and bidirectional associations between adiposity and SB and PA in children. Methods: Participants were 356 children in England. PA was measured at 7 and 9 years of age using accelerometry. Outcome and exposures were time in SB and PAs and concurrent body mass index z score and fat index (FI). Results: Adiposity at baseline was positively associated with changes in SB (β = 0.975 for FI) and negatively associated with changes in moderate to vigorous PA (β = −0.285 for body mass index z score, β = −0.607 for FI), vigorous PA (β = −0.095 for FI), and total PA (β = −48.675 for FI), but not vice versa. The changes in SB, moderate to vigorous PA, and total PA for children with overweight/obesity were significantly more adverse than those for children with healthy weight. Conclusions: A high body mass index z score or high body fatness at baseline was associated with lower moderate to vigorous PA and vigorous PA after 2 years, but not vice versa, which suggests that in this cohort adiposity influenced PA and SB, but the associations between adiposity and SB or PA were not bidirectional.

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Mark S. Tremblay, Silvia A. Gonzalez, Peter T. Katzmarzyk, Vincent O. Onywera and John. J. Reilly

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Jane F. Hislop, Cathy Bulley, Tom H. Mercer and John J. Reilly

The objectives of this study were to explore whether triaxial is more accurate than uniaxial accelerometry and whether shorter sampling periods (epochs) are more accurate than longer epochs. Physical activity data from uniaxial and triaxial (RT3) devices were collected in 1-s epochs from 31 preschool children (15 males, 16 females, 4.4 ± 0.8 yrs) who were videoed while they engaged in 1-hr of free-play. Video data were coded using the Children’s Activity Rating Scale (CARS). A significant difference (p < .001) in the number of minutes classified as moderate to vigorous physical activity (MVPA) was found between the RT3 and the CARS (p < .002) using the cut point of relaxed walk. No significant difference was found between the GT1M and the CARS or between the RT3 and the CARS using the cut point for light jog. Shorter epochs resulted in significantly greater overestimation of MVPA, with the bias increasing from 0.7 mins at 15-s to 3.2 mins at 60-s epochs for the GT1M and 0 mins to 1.7 mins for the RT3. Results suggest that there was no advantage of a triaxial accelerometer over a uniaxial model. Shorter epochs result in significantly higher number of minutes of MVPA with smaller bias relative to direct observation.

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Jane F. Hislop, Cathy Bulley, Tom H. Mercer and John J. Reilly

This study compared accelerometry cut points for sedentary behavior, light and moderate to vigorous intensity activity (MVPA) against a criterion measure, the Children’s Activity Rating Scale (CARS), in preschool children. Actigraph accelerometry data were collected from 31 children (4.4 ± 0.8 yrs) during one hour of free-play. Video data were coded using the CARS. Cut points by Pate et al., van Cauwenberghe et al., Sirard et al. and Puyau et al. were applied to calculate time spent in sedentary, light and MVPA. Repeated-measures ANOVA and paired t tests tested differences between the cut points and the CARS. Bland and Altman plots tested agreement between the cut points and the CARS. No significant difference was found between the CARS and the Puyau et al. cut points for sedentary, light and MVPA or between the CARS and the Sirard et al. cut point for MVPA. The present study suggests that the Sirard et al. and Puyau et al. cut points provide accurate group-level estimates of MVPA in preschool children.

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Louise A. Kelly, John J. Reilly, Diane M. Jackson, Colette Montgomery, Stanley Grant and James Y. Paton

Tracking of total physical activity (PA), moderate to vigorous activity (MVPA), and sedentary behavior was assessed in 42 young children (mean age at baseline 3.8 years) over a 2-year period using the Actigraph accelerometer. Tracking was analyzed using Spearman rank correlations, percentage agreements, and kappa statistics. Spearman rank correlations were r = .35 (p = .002) for total PA, r = .37 (p = .002) for MVPA, and r = .35 (p = .002) for sedentary behavior. Percentage agreements for PA, MVPA, and sedentary behavior were 38, 41, and 26 respectively. Kappa statistics for PA, MVPA, and sedentary behavior ranged from poor to fair. Results suggest low levels of tracking of total physical activity, MVPA, and sedentary behavior in young Scottish children over a 2-year period.

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Abigail Fisher, John J. Reilly, Colette Montgomery, Louise A. Kelly, Avril Williamson, Diane M. Jackson, James Y. Paton and Stanley Grant

This study examined whether there was a significant seasonal variation in objectively measured habitual physical activity and sedentary behavior in young children. Participants were children who attend nursery in Glasgow, Scotland, and measurements were taken using uniaxial accelerometry over 3 to 6 days. There were small but significant seasonal associations with physical activity and sedentary behavior (ANOVA: p < .001 in both cases). Total physical activity (accelerometry cpm) was significantly lower in spring than in summer, fall, and winter. We also found slight but significant seasonal variations in time spent in low-intensity activity and in moderate-to-vigorous-intensity activity. Sedentary time was significantly lower in summer vs. spring and in fall vs. spring. The present study suggests that seasonality plays only a limited role in physical activity and sedentary behavior in young children in our setting. Single measures of these variables should be adequate for research purposes in the absence of marked seasonal variability. In our sample and setting, the limited degree of seasonality precluded identification of major seasonal barriers to and opportunities for physical activity.